Exam (elaborations)

Sharp ESO Exam Questions with all correct Answers

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Sharp ESO

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eso

Institution Sharp ESO
Course Sharp ESO

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Sharp ESO Exam Questions with all correct Answers

3 types of Ventricular Tachycardia: - ANSWER-1. Stable

2. Unstable

3. Pulseless

.antecubital vein – ANSWER-First target for IV access if a central line is not
present

.Asystole – ANSWER-i. CPR (2 min.)

ii. O2 at 15 L/min. Ambu bag

iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/ml), repeat every 3-5
minutes

iv. Repeat CPR and epinephrine administration if no signs of ROSC

.Asystole treatment – ANSWER-Asystole represents total absence of
ventricular activity/contraction. There is no pulse associated with this
rhythm. Initiate CPR immedicately.

a. CPR for 2 minutes

b. O2 at 15ml/min. Ambu bag (10 breaths per minute)

c. Epinephrine 1mg IVP/IO (Use Epinephrine 0.1mg/ml) repeat every 3-5
minutes

d. Repeat CPR and Epinephrine administrations if not signs of ROSC

-NO defibrillation

-Transcutaneous pacing for asystole is not recommended as it is ineffective

.Asystole treatment – ANSWER-i. CPR (2 min.)

ii. O2 at 15 L/min. Ambu bag

iii. Epinephrine 1 mg IVP/IO (use epinephrine 0.1 mg/ml), repeat q 3-5
minutes

,iv. Repeat CPR and Epinephrine administration if no signs of ROSC

.Availability of medications required for ESOs: - ANSWER-Medications that are
part of an ESO must be readily available for administration to the patient

.Bradycardia unstable (Heart Rate less than 50bpm) – ANSWER-i. O2 at
minimum 10L/min. Non-rebreather mask

ii. If transvenous leads or epicardia pacing wires present, connect to a pulse
generator and initiate pacing per protocol.

If no response, perform the following:

iii. Atropine 1mg IVP/IO, repeat every 3-5 minutes (max 3 mg)

iv. Transcutaneous pacing as soon as possible.

v. If above algorithm is ineffective, start dopamine 400mg/250ml D5W
infusion at 5mcg/kg/minute. Titrate to patient response up to
20mcg/kg/minute.

vi. If above is ineffective, start epinephrine 2mg/250ml NS at 2mcg/min.,
titrate to patient reponse up to 10mcg/minute

NOTE: Assess patient for adequate intravascular volume and volume status
when using vasoconstrictors.)

.Bradycardia-Unstable (includes heart blocks) – ANSWER-1. Bradycardia is
defined as heart rate less than 50 beats per minute. This rhythm is too slow
to maintain an adequate blood pressure.

2. The patient must be symptomatic, exhibiting one or more of the
“unstable” signs/symptoms related to the slow rate.

3. Bradycardias range from sinus bradycardia to complete, third degree heart
block.

.Chest Pain – ANSWER-i. O2 start at minimum 4L/min. NC and titrate to
maintain SPO2 greater than or equal to 94%.

, ii. Nitroglycerin 0.4mg sublingual if SBP greater than or equal to 90 mmHg
and HR greater than 50. May repeat every 3-5 minutes x2.

iii. Morphine sulfate 2mg IVP/IO, if SBP greater than or equal to 90 mmHg
every 5 minutes up to a total of 10mg.

iv. Give aspirin 325 mg non-enteric coated, chewed or crushed. If not
contraindicated and no dose give on this date.

v. If hypotension develops and no evidence of pulmonary congestion, give
250ml NS IV/IO (may be substituted with LR if currently infusing) and resume
treatment for chest pain if not relieved.

vi. 12 lead EKG

.Chest pain – ANSWER-The most common presentation of an acute coronary
syndrome (ex: unstable angina; non-Q wave MI; Q-wave MI

.Chest pain suggestive of ischemia may be described as: - ANSWER-a.
Uncomfortable pressure, fullness, squeezing, or pain in the center of the
chest lasting several minutes (usually more than 15 minutes)

b. Pain spreading to the shoulders, neck, arms, jaw; or pain in the back or
between the shoulder blades

c. Chest discomfort with light-headedness, fainting, sweating, nausea, or
shortness of breath

d. A global feeling of distress, anxiety or impending doom

It is important to respond immediately when symptoms of myocardial
ischemia are present. A high priority is to provide pain relief.

.Circumstance under which an ESO Competent RN may perform ESO
standarized procedures: - ANSWER-Emergency standing orders will be
initiated by ESO competency-validated RNs in the absense of a physician.

.Coarse and fine V Fib – ANSWER-Used to describe the amplitude of the
rhythm

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